“ASSERTED”

Pro-rector on educational work

Prof. Yu.I.Guminsky

“____” ______2013

THE THEMATIC PLAN

of practical lessons on general surgery for third year students

To
pic / Contents / Ho
urs
MODUL 1
Acquaintance of students with the rules of conduct in a surgical clinic. Certain aspects of surgical deontology. The structure of a surgical clinic. Patient’ care principles at the reception. Sanitization of patients. Anthropometry. Transportation of patients. Sanitary and hygiene regime at a surgical department, its significance in fighting hospital infection. Organization of paramedical personal work, nurse’s post. Duties of senior nurse and nurse on the post. Working principles at the manipulation cabinet. Medical documentation. Medical manipulations: injections; technique of drug introducing; taking temperature.Testing control. / 2
The main principles of patients’ care at the clean dressing-room. The structure of the dressing-room. Organization of dressing room’s functioning. Bandages’ imposition. The types of dressing material and its characteristics. Typical modes of bandaging. The rules of bandages The main principles of caring patients after operative interventions on head and neck. Typical modes of bandaging The main principles of caring patients after the operative interventions on thorax and upper extremities. Typical modes of bandaging/ Testing control. / 2
The main principles of caring patients after the operative interventions on abdominal cavity organs, perineum, lower extremities. Typical modes of abdominal, perineal, lower extremity bandaging. Care for patients with fractures of bones and joints. The main principles of putting the plaster. Types of plasters. Testing control. / 2
The main principles of patients’ care with purulent pathology. Organization of purulent dressing-room work. The principles of modern antiseptics. Utilization of purulent dressing material. The particularities of dressing and care for patients with gas-gangrene / 2
The principles of making surgical serviettes, tampons, gauze-balls; preparation of operative linen, dressing material for sterilization, its stacking into the Shimmelbush’s drums. The structure and functioning of the autoclave. The principles of sterility control The structure and functioning principles of operating room. The methods of cleaning. The methods of patients’ transportation to the operating room. The principles of sterilization of surgeons’ hands and operative region. The rules of wearing the operative clothing. (the lesson is conducted at a surgical block) / 2
The organization of functioning of sterilization room. The preparation of instruments for the sterilization. The modes of controlling the quality of instruments’ pre–sterilization. The modes of sterilization of cutting, optical, general surgical instruments. The sterilization of suturing material.Testing control. / 2
A surgical operation. The stages of an operation. Pre-operating period and its tasks. The preparation of the patients to the planned operation. Skin care and hear shaving, enema. The hygiene of patient’s linen and wear. Oral cavity sanation. The specific of preparation for the urgent operations. Patient care in postoperative period. The prophylactics of possible complications. Feeding of patients. The specific of care for aged and agonic patients. Testing control. / 2
MODUL 2
Hemorrhages. Determination and types of hemorrhages. Blood loss, ways of its determination. The modes of temporary arresting of a hemorrhage. Clinical case review. Hemorrhages. The modes of permanent arresting of a hemorrhage: mechanical, physical, chemical, biological. Vessel suture. Transplantation, alloplasctics. Clinical case review. Testing control. / 2
Basic knowledge on blood. Blood group and rhesus-factor determination. Determination of individual, biological and rhesus-factor cross-match, / 2
Blood transfusion. Indications and contraindications. Mechanism of blood and blood components action. Ways and routes of transfusion. Blood quality determination. Patients’ supervision during the transfusion. Documentation. Blood substitutes classification.
Possible mistakes and complications of blood transfusion. Classification, pathogenesis, clinics, treatment of possible complications. Prophylactics Testing control. / 2
MODUL 3
Anesthesiology. Types of local anesthesia (layered infiltration, regional, spinal, intraosseal). Indications, contraindications. Possible complications. / 2
Anesthesiology. Inhalational narcosis and its types. Mask, endotracheal. Testing control Anesthesiology. Non-inhalational narcosis: i/v, i/m, i/a, rectal. Indications and contraindications. Complications. Anesthesiology. Complications of inhalational narcosis according to the stages and levels. Diagnostics and treatment. Testing control. / 2
Intensive care and cardiac resuscitation. Testing control. Gaining skills on phantom. Testing control. / 2
MODUL 4
Wounds and wound process. Determination. Classification and structure of the wounds. General questions of the wound process development, the types of wound healing. Clean operative wound. Clinical case review. Wounds. The reasons of wound infecting. Removing the wound infection. Clean wounds treatment. Practical work in clean dressing room. Clinical case review / 2
Wounds. Infected wounds. Treatment and healing. The periods of wound process development. Primary surgical processing of the wound. Secondary surgical suture. Practical work in dressing room for purulent processes. Clinical case review. Testing control. / 2
The closed injure of soft tissue scull, thorax, abdomen, cavity organs. The reasons of injure. Classification. Clinics. Methods examine. The first aid / 2
Fractures. Determination. Classification. Mechanism. Diagnostics. Types of fractures, mechanism, types of displacement. Bone callosity development. Clinical case review.. Fractures. Treatment. Ways of transport immobilization. Types of splints. Self-made splints. Methods of applying splints. (Practical self-instruction). Testing control / 2
Fractures. Treatment in the hospital conditions. Main tasks. Prophylactics of shock. Minimizing blood-loss. Main methods of conservative treatment. Anaesthetization. Reposition, reduction, plasters, Illizarov device. Skeletal extension. Operative treatment. Clinical case review. Dislocations. Determination. Classification. Mechanism. Diagnostics and differential diagnostics. Treatment of dislocations. Clinical case review. Testing control. / 2
Burns. Classification according to the depth and square. Square and severity of burns. The burn disease periods. Primary surgical care of burn surface. Clinical case review. Burns. The treatment of burn disease according to its periods. / 2
Congelation. Classification, pathogenesis, treatment. Clinical case review. Shock, collapse, fainting, syndrome of prolonged compression. Testing control. / 2
MODUL 5
Acute purulent unspecific infection. Work at the purulent dressing room. (Practical self-instruction). Acute purulent infection. Abscesses, phlegmons, furuncles, carbuncles. Clinical picture. Clinical management. Working with patients. Testing. (Practical self-instruction). / 2
Acute purulent infection: hydroadenitis, mastitis, erysipelas, lymphadenitis, lymphangoitis, paraproctitis. / 2
Acute purulent unspecific infection: agnail and phlegmon. Etiology, particularities of course, diagnostics, clinical management. Indications for operative care, its character, methods of anesthesiology. Testing.
Plegmon of hand. Anatomy of tendons space, circulation, innervation. Etiology, classification, clinics, management. / 2
Acute purulent unspecific infection: acute haematogenic osteomielitis. Pathogenesis, diagnosis, management. Ways of operative care. Chronic forms of osteomielitis, management. Clinical investigation of a patient. Testing. / 2
Anaerobic gas gangrene. Etiology, pathogenesis, clinical signs, prophylactics, management. Care details. Tetanus. Etiology, pathogenesis, clinical. Unspecific and specific prophylactics. Management / 2
Sepsis. Etiology, pathogenesis, clinical course, management / 2
Chronic purulent unspecific infection: osseal - joint tuberculosis. Etiology. Pathogenesis and pathologic anatomy. Clinical signs. Early and late signs. Principles of management. Testing / 2
Necrosis. Fistula, ulcers. Types, etiology, differential diagnosis, management. Clinical case. Obliterating endarteritis. Acute and chronic thrombophlebitis. Clinical case. Testing / 2
MODUL 6
Tumors. Classification of clinical groups. International classification (T-N-M). Differential diagnostics of malignant and benign processes. Clinical signs of different tumors. Testing. / 2
MODUL 7
Surgical policlinics. Acquaintance of students with the work in policlinics. Clinical cases analyze. (Practical self-instruction). / 2
Workshop at the operative block. Particularities of patients’ preparation for urgent and planned operations. Rules of aseptic and antiseptics. Temporary and final arrest of bleeding. Anesthesia / 2
MODUL 8
Methodology of examination of surgical patients. Patient’s anamnesis collection and its importance in diagnostic of main and concomitant pathology in patients with acute and chronic diseases. Objective examination of the head, thorax. (Practical self-instruction). / 2
Methodology of examination of surgical patients. Objective examination of abdomen, muscle skeletal system. Learning the conscention of using the method of objective examination in surgery. Role of acquired data in verification of diagnosis (Practical self-instruction). / 2
Curation surgical patients. Analysis and assessment of the written histories. (Practical employment-I). / 2
Curation surgical patients. Analysis and assessment of the written histories. (Practical employment-II). / 2
Learning the scheme of case history. Allocation of patients between the students. (Practical self-instruction). / 2
differentialoffset / 2
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The chief of the general surgery department prof. M.D. Zheliba

of VinnytsiaNationalMedicalUniversity